Problem gambling severity and the incidence of Axis I psychopathology among older adults in the general population

Abstract

To examine the longitudinal relationship between past-year problem-gambling severity and incident Axis I psychopathology among older adults (aged 55 to 90), analyses were conducted on data from the National Epidemiologic Study of Alcohol and Related Conditions (NESARC). This nationally-representative population-based survey was conducted in two waves (Wave 1, 2000-2001; and Wave 2, 2004-2005). Past-year problem-gambling severity at Wave 1 and incident Axis I psychopathology at Wave 2 were evaluated with the Alcohol Use Disorder and Associated Disabilities Interview Schedule—Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition. Multivariate logistic regression modeling was conducted on groups categorized into low-frequency gambling/non-gambling (LFG/NG), low-risk gambling (LRG), and at-risk/problem/pathological gambling (ARPG) based on DSM-IV criteria for pathological gambling. Relative to LFG/NG, ARPG at Wave 1 was positively associated with the incidence of generalized anxiety disorder (OR=2.51; p=.011) and any substance use disorder (OR=2.61; p=.0036); LRG was negatively associated with the incidence of hypomania (OR=0.33; p=.017). Models were adjusted for demographic characteristics, psychiatric comorbidity, health behaviors, physical health, and stressful life events assessed at baseline. While gambling may represent a positive activity for some older adults, data suggest that risky/problematic gambling behavior may be associated with the development of psychiatric problems in this population. Older-adult gamblers, as well as their clinicians, friends, and family, should be aware of potential risks associated with gambling, adopt strategies to prevent the onset of secondary disorders, and monitor themselves and others for signs of problems.

Gambling disorder in older adults: A cross-cultural perspective

“…There are reports that older adults - subjects aged 60 or older according to the World Health Organization (2) - who gamble recreationally could potentially have greater well--being relative to non-gamblers (3). However, there is strong evidence suggesting that Gambling Disorder (GD) in this age range is increasing and became an important public health issue in different countries (4,5,6). GD arises when the gambling behavior is persistent, recurrently problematic and leads to clinically significant impairment or distress (7).…”

“…GD arises when the gambling behavior is persistent, recurrently problematic and leads to clinically significant impairment or distress (7). Several factors contribute to the increased prevalence of GD in older adults such as the ageing of the world population (6) and the larger gaming availability worldwide (5). …”

“…Despite its importance, little research has focused specifically on GD in older adults (4,5,6). Research to date has suggested that older adults with GD may have unique clinical presentations (i.e.…”

“…Research to date has suggested that older adults with GD may have unique clinical presentations (i.e. older age of onset, greater rates of anxiety disorders), may have different motivations for gambling, and different consequences from gambling compared to younger gamblers (6,8,9,10). Therefore, older adults may require a special approach due to their particular general and mental health needs.…”

“…Therefore, older adults may require a special approach due to their particular general and mental health needs. (6,11). However, apparently GD has different presentations depending on sociocultural factors(1).…”